Mosquito nets become fish nets

from All Africa

Instead of using mosquito nets to protect themselves from malaria, this group of fisherman use them to make a living. - Kale

The Monitor (Kampala)

By Fred Simiyu

Living a day at a time and crossing the bridge when you reach it is all what seems to matter to most of the Mayuge residents, especially those living along the shores of lake Victoria, whose main means of survival is fishing.

The residents much to the disappointment of the local authorities are using mosquito nets to catch fish. They also turn testse fly traps into garments. Mayuge is one of the districts that has been greatly affected by malaria and sleeping sickness.

And this is the reason why Farming in Tsetse fly Controlled Areas, a non government organisation has for the past three years supplied chemically treated nets to kill mosquitoes and tsetse flies that cause malaria and sleeping sickness.

But the fishermen think the nets can better be utilised in catching fish. The residents are also stealing tsetse fly traps and use them as garments much to the chagrin of entomologists and vermin control personnel in the district.

These illegal activities have led to the increase of Tsetse flies and mosquitoes in the area, a situation which has direct negative impact to the communities as health officials warn of increased cases of malaria and sleeping sickness in the area.

Mr Valentine Oketh, an official from the NGO in charge of distribution and setting up of the vermin traps, narrates how disappointed he gets when residents steal the traps soon after he has set them up.

"Most tsetse fly traps set out are stolen by residents and converted into clothes to wear or bed sheets," he says. "I am worried that some of the residents might bring rags into close contact with children or use them to cover food and kill themselves in the process. Dangerous chemicals are applied on the traps, and this could harm the people." Whenever the traps are taken away, according to Oketh, tsetse flies are empowered to freely spread the disease.

As Mr. Oketh still worries about the risks the residents are facing, the island dwellers and the fishermen on the shore line are on the other hand converting most of the 39,000 treated mosquito nets recently donated to them by government into fishing nets.

Government donated the nets to Mayuge in June this year through the Ministry of Health to fight the increased spread of malaria in the district.

However, the Baitambogwe and Imanyiro Beach Management Unit Joint Committee Chairman Patrick Basoga revealed recently that fishermen were using the nets to catch small fish species locally known as 'mukene'.

"To a certain extent the existence of adverse poverty has compelled most residents to lose sense of protection against the deadly disease vectoring insects," says Ms Annet Nasubo Sentongo, a district councillor for Baitambogwe.

The area leaders say that although malaria is the leading killer disease in the district, the biting poverty has led the fishermen to illegally convert mosquito nets into fishing gear.

"Since the fishermen are now too poor to afford the ever increasing prices of fishnets this seemed an opportunity to continue catching more fish without buying nets," says Mr Basoga.

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WHO says malaria still a major challenge in Africa

from All Africa

An official from the WHO talks about the challenges in getting quick malaria diagnosis in Africa. - Kale

BuaNews (Tshwane)

The African continent is loosing up to $12 billion per year of its Gross Domestic Product in scaling up malaria intervention programs, according to the World Health Organisation (WHO).

WHO country representative, Olusegun Babaniyi said malaria remains a global threat to the attainment of social-economic targets, with three million and more cases and an estimated one million deaths annually.

Dr Babaniyi was speaking on Monday at the official opening of the Eastern and Southern Africa Annual Review and Planning Malaria Meeting, themed "Improving Malaria Diagnosis".

The theme of the meeting is timely, he said, adding that it serves as a reminder of the need for African countries to pay attention to diagnosis in order to eradicate poverty.

He said malaria has kept the poor people poorer, adding that it is consuming 25 percent of household incomes.

Dr Babaniyi also emphasised the need for countries to improve the health provider's confidence in malaria diagnostic results.

"The prompt use of microscopic examination in the diagnosis of malaria is vital, as it aids the management of the diseases by confirming clinical suspicion which also saves money and reduces evolution of drug resistance."

The lack of confidence, he said, in the diagnostic results by health providers emanates from limited trust in the quality of diagnostic services.

"It is for this reason that the WHO has developed a comprehensive manual on quality of microscopy and other diagnostic techniques in an effort to strengthen quality assurance and quality control in malaria diagnosis among countries," Dr Babaniyi said.

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Malaria Millennium Development Goal 'unlikely to be met'

from Science Centric

A medical journal publishes a study on the MDG to fight malaria. The study cites lack of funding as a primary reason. - Kale

The Millennium Development Goal (MDG) to halt and begin to reverse the incidence of malaria globally is unlikely to be met, according to Wellcome Trust Principal Research Fellow Professor Bob Snow. The statement comes in a report published in the open access journal PLoS Medicine.

The eight MDGs were established by the United Nations in 2000 with a view to tackling global poverty and health inequality. Goal 6 included the target to 'halt and begin to reverse the incidence of malaria and other major diseases.'

Malaria is one of the world's biggest killers, killing over a million people every year, mainly children and pregnant women in Africa and South-east Asia. It is caused by the malaria parasite, which is injected into the bloodstream from the salivary glands of infected mosquitoes. There are a number of different species of parasite, but the deadliest is the Plasmodium falciparum parasite, which accounts for 90 per cent of deaths from malaria.

According to research conducted as part of the Malaria Atlas Project (www.map.ox.ac.uk), over 40% of the world's population is at risk from infection from the P. falciparum parasite. Professor Snow and colleagues from the University of Oxford, who developed the map, have identified the areas where risk is moderate or high and areas where the risk is relatively low and compared this to levels of funding to control malaria in these areas. They also analysed where funding was allocated for malaria control from major donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the World Bank and the US President's Initiative, and from national governments.

'There is clearly a lot of good will from the international community to tackle malaria, but more money needs to be invested and this needs to be distributed more equitably,' says Professor Snow, who is based at the Kenya Medical Research Institute (KEMRI) in Nairobi, Kenya. 'If not, it is unlikely that the Millennium Development Goal to tackle malaria will be met.

'We need to map where the problems are and where investment is most needed if we are to target the funds more effectively. This has been one of the primary intentions of the Wellcome Trust-funded Malaria Atlas Project. Without a map we could easily be missing the target and wandering around in endless circles.'

In 2007, annual funding for malaria control, which includes insecticide-spraying, use of insecticide-treated bed nets and access to rapid diagnosis and medicine, amounted to US$1 billion - less than US$1 per person at risk. Around forty percent of this came from the GFATM, the rest from national governments and external donors. Previous studies have estimated the optimum amount required to tackle malaria to be between US$4-5.

The researchers found a wide range of regional disparity between risk levels and amount of money allocated to the area for malaria control. For example, Burma (Myanmar) received US$0.01 for each person at risk, compared to US$147 in Suriname, South America. Certain areas, such as Africa, the Americas and the Middle East, received appropriate levels of the funding disbursed, but there were large shortfalls in other regions, such as South East Asia and the Western Pacific regions.

'Sixteen countries - that's half of all the people at most risk - receive less than fifty cents for each person at risk,' says Professor Snow. 'This includes seven of the poorest countries in Africa and two of the most densely populated at-risk countries in the world, India and Indonesia.'

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Amanet launches free web courses

from IPP Media

A study course is being offered for free on the internet for African health researchers. - Kale

By Patrick Kisembo

The African Malaria Network Trust (Amanet) has launched a series of free web-based courses to strengthen the capacity of African health researchers and scientists in Health Research Ethics (HRE) and Good Clinical Practice (GCP).

Speaking at the launch yesterday in Dar es Salaam, Amanet managing trustee Prof Wen Kilama said demand for the courses had surpassed supply despite numerous training workshops.

With over one thousand beneficiaries, he said launching of the series of courses not only addressed the gap, but underscored his pan-African organisation`s desire to safeguard the well-being of African health research participants.

``But we also need to reach out to the French-speaking research community in Africa because they have been deprived of such training, mainly provided in English,`` said Prof. Kilama.

The project is sponsored by the European and Developing Countries Clinical Trials Partnership (EDCTP).

The project works to accelerate the development of new or improved drugs, vaccines and microbicides against HIV/ AIDS, malaria and tuberculosis, with its focus being on phase II and III clinical trials in sub-Saharan Africa.

The organisation`s communication officer, Dr Charles Wanga, said 200 researchers and scientists had been trained on good clinical practice.

``The number is still very low compared to the demand. The introduction of the GCP course into free web-courses offered by AMANET will enable more researchers and scientists to access this important training,`` said Wanga.

He said the most important thing was to ensure that health research done by African researchers meet both ethical and scientific standards. ``We need to protect participants in human research through the strengthening of African ethics committees, scientists and their institutions on this regard,`` he said.

Previously, Prof Kilama said the disease burden among African countries prompted action from both the local and international communities.

``This has led to an unprecedented increase in health research activities in Africa. Despite established successes, health research involving humans has had its historical darkest moments of abusing research participants, particularly the vulnerable,`` he said.

The managing trustee said poor health delivery systems, lower levels of education and poverty of communities and governments made African populations highly vulnerable to abuse.

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Malaria Drugs Fuelling Antibiotic Resistance

from the Med Guru, India

Nearly 3 million people die from malaria each year. A study is reported in this article that shows that there mey be some side effect to malaria drugs. - Kale

Some commonly used malaria drugs may boost up the risk of resistance to a widely used class of antibiotics, despite never having taken the drugs before, a new Canadian study unfolds.

Rectal swabs from more than 500 villagers were checked for the bacteria, including those for E.coli and Salmonella.

Despite clear indications that these people have had no previous contact with such class of antibioticdefine drugs, researchers found that 4.8 percent of the people monitored had high resistance to Ciprofloxacin - an antibiotic from the fluoroquinolones family, which is chemically related to chloroquine, compared to the 4 percent found in US intensive care units where the drug is used intensively.

Tracking the cause of resistance, the researchers discovered that most of the study participants had been administered chloroquine - a drug that is commonly used to threat malaria. Interestingly, chloroquine has a composition similar to that of fluoroquinolones, researchers marked.

"This means that chloroquine use for malaria may make the fluoroquinolones less effective for many common tropical diseases such as typhoid fever, diarrhoeal illnesses, and possibly also tuberculosis and pneumonia in the developing world," Dr Michael Silverman from the Lakeridge Health Centre, Ontario marked.

"Together, these data suggest that we must focus our efforts on prevention of malaria using mosquito-control measures such as bednets and by developing vaccines," he added.

Malaria, an infectious disease caused by infected mosquitoes is most widespread in tropical and subtropical regions. Commonly associated with poverty, the typical symptoms include fever, chills, nausea, flu-like illness. In severe cases the infection can prove fatal.

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Doctors, activists work to stop clay eating in Africa

from the Globe and Mail

The practice of geophagy, widespread among pregnant women, can be harmful to the mother as well as the fetus

by KIM BARRY BRUNHUBER

MAKENI, SIERRA LEONE -- Aisha Jalloh takes one of the hard, smooth balls of clay and rolls it in her hand. It looks like a fossilized dinosaur egg.

"I know it is bad but I wanted to sustain the baby, so I eat it," she says, looking at her newborn daughter. While she was pregnant she would eat between 10 and 15 balls of clay each day. Sometimes she roasted them, sometimes she ate them plain. The old women in her community told her the clay would make her baby strong and remove "bad water" from her stomach.

"When I ate it, the vomiting stopped," she says. She understands the idea of gnawing on a rock-hard piece of clay may seem bizarre, but it's surprisingly common among her friends and family in rural Sierra Leone. Most mothers waiting with her at the maternity clinic admitted they also ate clay.

"It's cultural, it's traditional," said Ms. Jalloh's doctor, James Smith. "We have been telling them to stop taking these things."

The ingestion of earth or clay, known as geophagy, is a little-known but relatively widespread phenomenon in parts of Africa and Asia. It's usually consumed by pregnant or lactating women in order to reduce nausea and supplement a mineral-deficient diet. Some researchers suspect the clay coats the gastrointestinal tract and absorbs toxins, which is why a substance commonly found in the clay is used in some Western anti-diarrheal medicines. But it can also contain harmful parasites and cause lead poisoning, intestinal obstruction and colon rupture.

"It is not medicinal," said Osman Kamara, a local pharmacist who treats many women like Ms. Jalloh. "It leads to appendicitis and operations during delivery."

Dr. Smith said it may also affect the fetus by inhibiting the absorption of nutrients, especially if the clay is ingested in large quantities.

"During the first trimester it might contribute to congenital defects. Babies sometimes have defects, which at the end of the day parents attribute to witchcraft."

He and other area health practitioners have recently started trying to persuade their patients of the potential danger, but so far few women have been willing to listen.

"Illiteracy is very high among women ... about 75 per cent," Dr. Smith said. "We have been telling them to stop, but these people are poor and do not have an alternative."

Many women like Ms. Jalloh say they eat clay because they often can't afford food.

"Sometimes when I'm hungry, I will eat this because of poverty," Ms. Jalloh said. "It helps sustain my life."

Which is why some experts are now switching the focus of their campaign from the customers to the clay miners.

Not far from the hospital, an entire community labours in the midday sun, knee-deep in mud. The men dig the pits and sieve the clay. The children haul off the buckets, and add salt and herbs. The women break the clay into pieces and roll them into balls. The balls are then sold in bags of 12 at markets across the country. One bag sells for 100 leones, the equivalent of three cents.

"We are not happy doing it," said John Kamara as he wades back into the pit and pours out a bucketful of clay. In a good month he will earn about $60. "I hope after my children are educated they will take me out of this filth," he said.

Some community groups are hoping to curb clay-eating by giving the miners a way out.

"If they're going to stop, they need a substitute," said Ramatu Fornah of the Women's Action for Human Dignity, a community-based organization in the heart of Sierra Leone's clay-mining district. "We've targeted about 30 of them and are teaching them agriculture."

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“Ten million malaria patients in Myanmar”

from Radio Netherlands

by an RNW reporter

According to the World Health Organisation, malaria and AIDS are the two most devastating global health problems of our time. Together they cause more than four million deaths a year. They are both diseases of poverty and both of them cause poverty.

However, according to Professor Willem Takken, one of the pre-eminent malaria specialists in the Netherlands, the overall effect of malaria is greater than that of AIDS. This is chiefly because HIV/AIDS has also hit the western world, so there has been a stronger push to come up with successful treatments for the disease, which is not the case for malaria. Professor Takken explains:

"There are five to six million people who get malaria every year. A million die from it every year, but for those who don't, it still makes them seriously ill for a couple of weeks which means that they can't work."

And for people who are living on a daily wage, the loss of a week's wages has a direct impact on the family's food input.

Médecins Sans Frontières
In Myanmar, malaria is cited by medical NGO Médecins Sans Frontières (MSF) as being the number one cause of death. MSF has been fighting the disease for years in Myanmar where it now has 30 clinics that treat some 200,000 patients. Dr Frank Smithuis, himself a malaria specialist, is MSF Head of Mission in Yangon, the country's capital. He says:

"The WHO says that there are 500,000 malaria patients in Myanmar, but I know for a fact that's not true. I estimate it to be closer to ten million."

Mr Smithuis backs up the enormous discrepancy with the figures of MSF's own centre of operations in Rakhine state.

"Previously the clinics in this area used to see 30 patients a month. Since we started our diagnosis and treatment - which we give at a very low price of about eight cents per treatment - the number of patients seeking help in our clinics has increased 30-50 fold. So we saw the numbers of malaria patients increasing from 30 to 1800 in a month."

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Professor Reveals Latest Plant That Eradicates Mosquito

from All Africa

Daily Trust (Abuja)

By Abubakar Yakubu

The economic value of a plant called Cactus Opuntia (Ficus indica) was over the weekend in Abuja disclosed by Professor IK Aduba, who said it can fight the scourge of malaria as well as combat desertification, alleviate poverty, hunger and enhance better livelihood for man and livestock.

The professor also called on frontline buffer states of Nigeria to combat desertification and global warming through the plant.

"From the numerous pads being produced by this plant, the sap from the pads was used in 1911 by an American, Luther Burbank in Central Africa to smother the mosquito larvae found in exposed stagnant water bodies and environment," he stated

He said the effect lasted for 12 months, adding that the research report can be expanded and developed for commercial uses in Nigeria to fight the scourge of malaria.

"This bio- technology based on Cactus Opuntia is effective for the remedial impacts of the degraded landscapes of the frontline states, so as to revive agricultural and other socio- economic activities to create development, alleviate poverty and enhance better living conditions for the people," he added.

He said the plant has other potentialities apart from combating desertification, adding that the pads are of superior biomass for livestock feed, medicaments and biogas for cooking when dried.

"The fruits are delicious and nutritiously used for the production of confectioneries, solid food and cosmetics that can be exported to neighbouring countries," he explained.

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Scientists Report Advances in Diagnosing TB, Malaria, Sleeping Sickness

from the Voice of America

By Lisa Schlein

Scientists say progress is being made in developing faster, more affordable methods of detecting poverty-related diseases. A leading Swiss non-profit group, the Foundation for Innovative New Diagnostics, says it has made significant advances in creating better diagnostic tools for Tuberculosis, Sleeping Sickness and Malaria. Lisa Schlein reports for VOA from Geneva.

Millions of sick people in the developing world are unable to get the treatment they need because the illnesses they suffer from are not properly diagnosed and identified.

The Foundation for Innovative New Diagnostics has been working for the past five years on developing new tools to improve the quality of diagnosis to better fight poverty-related diseases. Its focus has been on three neglected diseases -Tuberculosis, Sleeping Sickness and Malaria.

Foundation for Innovative New Diagnostics chief officer Dr. Giorgio Roscigno, tells VOA the organization has several exciting new technologies in development and the World Health Organization has approved a few of them.

"We have now another major technology that is in the process of being approved by the World Health Organization, which is the detection of resistant strains in TB within one day, in contrast with the current four or five months that it takes to detect resistant strains," said Dr. Roscigno. "That could be a real, very important breakthrough and this should be, in fact, approved in the next one month. And, in Sleeping Sickness and in Malaria, we also are moving very fast toward the development of new diagnostic tools."

The World Health Organization considers tuberculosis to be one of the greatest threats to global health, with nearly nine million new cases and more than 1.1 million deaths each year.

More than 60 million people, most of whom live in rural sub-Saharan Africa, are at risk of Sleeping Sickness and Malaria causes more than 300 million cases. Most of the one million yearly deaths occur in young children in Africa.

Dr. Roscigno says too many people in poor countries suffer needlessly and die from preventable and treatable diseases because effective and appropriate diagnostic tools are not available.

He says the Foundation's new simple and affordable test for diagnosing TB will also detect whether patients are resistant to the antibiotics used for treating tuberculosis. He says its approval will be valuable for countries with limited resources

"The implications of this is quite very important in countries, because the fact that you are building resistance is an indicator of how good your program is," said Dr. Roscigno. "And on the other hand, preventing immediately or putting up corrective measures as soon as you start building resistance is a very important public health measure."

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[Comment] Jeremy Laurance: Bringing effective help to those who most need it

from the Independent

For Western travellers to malarial parts of the world such as sub-Saharan Africa, Asia and south America, the parasite holds few terrors. Dose yourself with the right prophylactic drug – Malarone is the current gold standard for areas where there is drug resistance – douse yourself with insect repellent and you are unlikely to fall victim to the lethal disease.

The indigenous population has fewer choices. Prophylactic drugs, at about £2 a day for Malarone, are beyond their reach. Bed nets, impregnated with insecticide, offer effective protection at minimal cost and millions have been distributed by charities. But most people in the affected countries accept malaria as an illness to be endured, suffering regular attacks.

The usual response to a fever was to reach for a dose of chloroquine, available for a few pennies from any village store. For 40 years, chloroquine was the standard treatment for malaria. Sufferers swallowed a couple of pills at the onset of the sweats that signalled infection and within 48 hours they would be better. It was safe, effective and cheap.

But, in recent decades, a drug-resistant strain of malaria, Plasmodium falciparum, has grown across the world and now accounts for over 90 per cent of cases in Africa. Surveys in east Africa in the late 1990s showed that almost two-thirds of patients given chloroquine and nearly half of those on its successor, sulfadoxine-pyrimethamine, died.

Children, with their undeveloped immune systems, are especially vulnerable. More than eight out of 10 malaria deaths occur in sub-Saharan Africa and the World Health Organisation estimates that the disease kills 3,000 children a day. In countries such as Malawi, the disease claims more lives each year than Aids, yet receives a fraction of the attention, even though children are its chief victims.

In 1998, the WHO launched the Roll Back Malaria programme with a target to halve the number of deaths by 2010. Instead of declining, however, in the early years of the programme the toll rose by a quarter and by up to half in some areas. The UN identified the disease as one of the top four causes of poverty with many African governments spending up to 40 per cent of their health budgets on malaria control. Current spending on malaria in Africa is estimated at $1bn (£500m) a year.

Countries worst affected by the disease have been reluctant to buy the new artemesinin-based drugs because, at $1 to $2, a dose they are 10 times more expensive than chloroquine.

The promise of an unlimited supply of affordable artemesinin from the partnership between the Gates Foundation and the French pharmaceutical company, sanofi, will make effective treatment accessible once more to the people in greatest need.

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How Malaria Impoverishes Country

from All Africa

Until recently malaria was only known as the leading killer disease in Uganda and sub-Saharan Africa. But studies from the Ministry of Health indicate the disease is also the leading cause of poverty.

This is because it has serious impact on the economic, social and cultural aspects of society.

A study carried out in 2002 in Uganda identified ill health as the most frequent cause of poverty. The study showed that a poor malaria-stricken family might spend up to 25 per cent of its income on malaria treatment and prevention. There are also direct costs in form of treatment, treatment seeking and funeral expenses.

Industry

Malaria leads to loss of household incomes through absenteeism from work. It is estimated that workers suffering from a malaria bout can be incapacitated for five to 20 days. A study showed that a high percentage of employees were absent from work due to malaria.

In Apac District 54 per cent of workers cited malaria as the reason for absenteeism, in Kampala 33 per cent and 50 per cent in Rukungiri. On the average out of seven working days, between four to nine days were lost per malaria episode. This means that recovery would take longer than a week in some workers.

During such a period some companies pay for workers' treatment while the employees are not productive at the moment. Company production is affected leading to lower profit levels and higher costs of production. And this occurs several times a year in many families.

This affects the national budgets because the lower the output, the lower the taxes paid to the government. As such, the government cannot meet the obligation of providing services such as in health, thus creating a vicious cycle of poverty.

Apart from direct effects of malaria to industries is the additional low demand level. A sick and perennially poor population has low consumption levels. Because of low household incomes, such a population can hardly afford basic necessities in life.

This makes it difficult for such a country to attract investment because of the small market available. The opportunities that go with investment (jobs, taxes, social infrastructure and a higher standard of living) are lost.

In industry and agricultural enterprises like tea, sugarcane, coffee, rice, tobacco estates, malaria accounts for the greatest number of man-hours lost, which maybe up to or more than 50 per cent all the man-hours lost. This affects production and revenue for the industry, families and the nation as well.

Malaria also leads to loss of investment funds thus affecting the economy. It is known that investors are not much interested in investing in countries where most of their profits will be eroded through absenteeism from work due to malaria and on treatment of malaria infected workforce.

Agriculture, Education

This means there are high chances that children in such families will not be able to attend school. This affects performance. It is estimated that in endemic areas like Uganda, malaria may impair as much as 60 per cent of the schoolchildren's learning ability.

Children from such families will perform poorly, go to poor schools and have fewer or no opportunities to higher education. This makes them miss out on good employment opportunities and they end up doing low skilled labour intensive jobs.

In case the dead person is the breadwinner for the family, children will automatically drop out of school and are condemned to living a wretched life.

In agriculture, the period parents (mostly mothers) spend nursing sick children is lost whereas it could be used to grow crops for food and income.

Hence, an episode of malaria affects health, education, agricultural activity and food security. All these build up to increasing poverty in homes.

Statistics from the Ministry indicate that malaria afflicted families on the average can harvest only 40 per cent of the crops.

It must be remembered that Uganda is basically an agricultural-dependent country. About 90 per cent of the population is engaged in agriculture. The country earns more from agriculture than from any sector. When this mainstay of the economy suffers, the very fabric of the country is threatened.

Malaria is transmitted by the anopheles mosquito and it spreads faster during the rainy season. Unfortunately this is the main farming season, when families can least afford to be sick. Hence malaria interferes with farm activities increasing poverty in homes.

Social-cultural Impact

Malaria has also caused serious socio-cultural consequences in families.

Frequent illness or deaths of children due to malaria can lead to misunderstandings within families (especially polygamous families) and between families.

Those with sickly children or children dying often arelikely to accuse others whose children do not fall sick or die often of bewitching their children, which may result into a fight or hatred.

Families with a lot of problems (frequent illnesses, poverty, low education levels and inability to fend for children) are usually unstable.

In most parts of rural Uganda (if not all) it is conceived insensitive if a person continues with farm work like digging. Until a person is buried no digging is permitted.

Yet during this period the bereaved families provide food for mourners although some neighbours assist.

This increases poverty and food insecurity as President Yoweri Museveni noted. Whereas food is being consumed, no production is taking place thus creating not only food deficit but increasing poverty since agriculture is the income earner in rural Uganda.

Cost of Treatment

Dr John Bosco Rwakimri, the National Malaria Control Programme manager in the Ministry of Health says Uganda loses at least $690 million to malaria every year. This is in terms of treatment, prevention, time lost due to sickness not counting burial expenses.

According to the Ministry of Health direct cost of treatment for an episode of malaria is estimated at Shs8,000 ($4.10) in urban settings and Shs3,300 ($1.80) in rural populations.

Assuming that 50 per cent of the 5,200,000 children under five years old currently in Uganda suffer an average of six episodes annually and are treated in health facilities at Shs2,000 per episode, then Ugandans are spending (50/100 x 5,200,000 x 6 x 2,000) = Shs31,200,000,000 annually for malaria treatment of the under fives only! (US$20 million, ed. note)

This does not include other expenses incurred, such as transport while seeking treatment, treatment for adults, and children over five years old, treatment of adults and children admitted in health facilities, the higher costs of treating the under 5s and other family members in private clinics and urban areas, chloroquine failures which require more expensive drugs, funeral expenses for children and adults who die, aerosol sprays, mosquito coils, mosquito nets and other mosquito control expenses.

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She battles disease, poverty in developing countries

from the Boston Globe

By Billy Baker

Dr. Joia Mukherjee really wants to be a singer. That, she has already decided, will be her second career, and she just has to finish her first career, this minor business of "getting all the world's HIV and poverty squared away," before she can get started in earnest.

"I brought a karaoke machine to Haiti last week," Mukherjee said recently in her office on Huntington Avenue, though her smile turns into a smirk when she notes that she never got to use it. She was too busy saving lives as the medical director for Partners in Health, a Boston-based organization dedicated to fighting poverty and healthcare inequality in impoverished countries.

In one single hour in Haiti, she said, the organization saved the lives of five children who would have died of malnutrition had they not been there to feed them some specially fortified peanut butter. Karaoke had to wait, though her face brightens again when she adds that she did get to lead a song for the president of Haiti.

Mukherjee is almost impossibly laid back as she tells such stories, a quality that, she says, is often maddening for her staff.

"It drives people crazy to see how low-key I am," she said. Her temperament is constant - playful, curious or, in her words, "quirky" - whether she's talking about fighting malaria or how unfair it is that she's too old, at 44, to be on "American Idol."

"Whenever I see her," said Jack Bryant, a former dean of the school of public health at Columbia University who has been doing work in Haiti for decades, "she has this intriguing quality of being both light-hearted and profound. She's an important person in the field of international health and development, but at the same time she doesn't grumble all the time."

Mukherjee says that she can be so pleasant about the unpleasant because the fight has been with her so long that it's just a part of who she is now. In 1972, when she was an 8-year-old girl growing up in suburban Long Island, her family took her to India. Her father, from Bangladesh, is a refugee from the India-Pakistan partition in the mid-50s (her mother is Irish-Catholic with red hair and freckles), and they arrived in the country at a time of great turmoil, when Bangladesh was separating from Pakistan and millions of people were being displaced.

She saw the squalid conditions of poverty. She saw kids her own age dying in the street. She saw people with leprosy. And she was outraged.

"I think children have a strong sense of social injustice," she said, "and I was never the same kid after that."

In the eighth grade, she read a Nelson Mandela speech that pointed to poverty as the root of the world's problems and decided, then and there, that would be her cause. When the AIDS epidemic broke during her college years, she realized it would disproportionately affect the poor, and she went to medical school intent on working on diseases of poverty. She spent six months in Kenya during her medical training, and, after that, she found it hard to work in the United States.

"I saw 50 kids die of malnutrition in Kenya, and came back and worked on a kid's heart transplant. I was glad to help the [American] child, and he deserved it, but it was all this work for one when a few dollars could have saved many. After that, I decided that the US had enough doctors and didn't need me."

Mukherjee, who is also on the staff at Brigham and Women's Hospital and an assistant professor at Harvard Medical School, now spends 75 percent of her time traveling abroad with her karaoke machine and her 22-month-old son, Che, as she helps to supervise Partners' efforts in 10 countries. The single mother trains local staff and works with governments to help establish national health networks, all with the goal of pushing forth the belief that healthcare is a basic human right.

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Contagious diseases still the scourge of Africa

from Asahi

Bacteriologist Hideyo Noguchi, who researched yellow fever in Africa in the early Showa Era (1926-1989), was struck down by the disease and died there in 1928 at the age of 51. It is said his death was due to the fact the vaccine he made did not work. His last words are said to have been: "I don't understand." Although times have changed, I feel those words reflect the horror of infectious diseases.

In commemoration of Noguchi's achievements, the government established the Noguchi Hideyo Africa Prize for medical research and health-care services related to Africa. The prize was presented for the first time Wednesday to coincide with the Fourth Tokyo International Conference on African Development (TICAD) in Yokohama.

One of the recipients of the prize, Dr. Brian Greenwood, is a British specialist on malaria research. He has lived in Africa for many years and, aside from his own research, has devoted much of his time to training local researchers. Although the local conditions are harsh, I heard his work has produced steady results.

But there is still a long way to go before the disease is eradicated. In Africa, 3,000 children are said to die every day of the disease, which is transmitted by mosquitoes. In sub-Saharan Africa, one out of every six children dies before he or she reaches the age of 5. Malaria is one of the major causes of infant deaths.

Malaria has also been dubbed the "disease of poverty." What little money residents have is used for prevention and treatment. The disease causes poverty, and poverty causes the disease to spread. Malaria is not the only disease that continues to plague the region. Eight decades after Noguchi's death, various infectious diseases such as AIDS continue to pose a major threat to people across Africa.

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World Unites to Kick Out Malaria

All Africa

The Times of Zambia (Ndola)

By Edward Mulenga
Ndola

APRIL 25, 2008 will obviously remain memorable to many Zambians. Livingstone, the tourist capital was honoured with hosting the inaugural World Malaria Day (WMD).

The occasion witnessed by notable figures, including Malaria goodwill ambassadors, Princess Astrid of Belgium and famous South African musician, Yvonne Chaka Chaka, brought together several dignitories whose respective roles, spelt out what can be achieved through collective efforts.

The Livingstone community was lifted up with the volume of activities undertaken prior to the day itself, which the residents described as an honour.

Anti malaria expedition notable among the events preceding the commemoration was the Zambezi River of Life Expedition (ZAROLE), which entailed a 2,500km voyage from its source in Mwinilunga, across six Southern African Development Community (SADC) countries Zambia, Zimbabwe, Angola, Namibia, Botswana and Mozambique, where it pours into the Indian Ocean.

The 2,500 km voyage, planned in Livingstone in February, 2000 and launched on March 29, 2008, under the leadership of German Journalist Helge Bendl and Swiss boating expert, Andy Leeman, has already show- cased successes and highlighting the challenges associated with fighting the disease which knows no borders and one of the leading infectious diseases.

During the expedition team's stop over in Livingstone for the World Malaria Day, Mr Bendl said the expedition had so far exposed several setbacks in the health care and thanked the Roll Back Malaria Partnership for making the exercise successful. "By exposing the difficulties of delivering mosquito nets and medications to remote areas, the Zambezi expedition will demonstrate that only a coordinated cross border action can force the disease to recoil and turn the lifeline of Southern Africa into a river of life to those threatened by Malaria," he said.

The expedition team found many Angolans walking to nearby Zambia for health services lacking in their country due to the 27 year war, as Mr Bendl commended Zambia's successful record of fighting Malaria although a lot still needed to be done in remote areas.

Mr Bendl, however, said the SADC region collaboration has kept the Malaria fight on course, towards remarkable success, although a lot more has to be done. As part of the multi-directional confrontation against the disease, 30 men cycled from Serenje and arrived in Livingstone on the WMD, covering a distance of more than 1000 kilometres. Health Minister Brian Chituwo, who is SADC health ministers chairman said the regional body has resolved to initiate joint control measures towards significantly reducing malaria illnesses and deaths in the region.

Dr Chituwo said through the Southern Africa Regional Network (SARN), centred on collaboration, it is necessary to work together to harmonise their vector control and anti malarial drug policies to standardise interventions in the region.

He said the Lubombo Spatial Development Initiative by South Africa, Mozambique and Swaziland was such an example of collaboration in fighting Malaria- with the Mozambique segment extended to prevent malaria from afflicting more than 500,000 people in the LSDI control areas. "In addition, the cross border initiative through the Trans-Zambezi initiative also demonstrates our commitment to ensuring that malaria is eliminated through joint activities in border towns," Dr Chituwo said.

Disease burden is a major public health problem in more than 90 countries, inhabited by almost 2.5 billion people, or 40 per cent of the world's population, malaria is estimated to kill child every 30 seconds and to cause up to 350 million new infections worldwide every year.

According to the WHO, malaria is the biggest killer disease for children in Africa (more than AIDS, TB or any other disease) and a primary cause of death and poverty, with over 60 prevalence and 90 per cent deaths recorded in Africa.

About 350 to 500 million infections and over one million deaths, mostly among the young in Africa are recorded annually. "With between one and three million deaths recorded annually and 3,000 children deaths daily, malaria remains one of the globe's leading infectious killers with most victims being children under the age of five and pregnant women," the WHO report says.

Malaria's catastrophic economic impact by taking up 40 per cent of developing countries health expenditure which coupled with its burden on families, is undermining development in some of the poorest countries in the world, malaria remains an economic catastrophe.

According to the RBM partnership, Africa loses $12 billion in productivity annually, as annual economic growth of malaria-endemic countries stands at 1.3 per cent lower than non malaria-endemic nations, while countries which have brought down malaria like Mozambique, have recorded improved growth. The WHO also estimates that sub-Saharan Africa's Gross Domestic Product (GDP) would be up to 32 per cent greater today had malaria been eliminated 35 years ago. This would mean up to $100 billion added to the region's current GDP, a sum nearly five times greater than all development aid provided to Africa in 2007.

To reverse this repugnant situation, stakeholders made several contributions to the reduction of malaria on the eve of the WMD in Livingstone. PermaNet donated 300 insecticide treated nets (ITNs) to the Livingstone General Hospital, while other global partners also reaffirmed their commitment to malaria fight.

Director of public relations and communication, Peter Cleary said 1,500 more nets had been presented to the expedition team for distribution to Zambians settled along the Zambezi River, from its total of 135million nets produced since inception in 1992.

"We believe that our work and that of our partners will one day afford all humanity the basic human rights that so many are currently without. We are proud to sponsor the Zambezi River of Life Expedition, bringing good health and hope to the people of the river of life," Mr Cleary said.

Princess Astrid led other dignitaries in touring and presenting ITNs to the Livingstone General and Batoka hospitals and saluted all the partners for their commitment to fighting the killer disease.

Roll Back Malaria Partnership(RBM) executive director Dr Awa Marie Coll-Seck saluted the partners for their commitment as shown through their support to the expedition and called for more material and financial support.

Medicines for Malaria Venture (MMV), an anti Malaria drug manufacturing company, vice-president for public affairs, Anna Wang said it is important to cut the transmission cycle of the disease.

According to Ms Wang, MMV manages the largest portfolio of malaria drug research with over 40 projects in different stages involving more than 600 scientists. "MMV's goal is to make a public health impact and meet the needs of the 3.2billion people at risk from this deadly disease," she said.

And Malaria Control and Evaluation Partnership (MACEPA) official, Judith Robb McCord said it is important to continue mobilising global commitment to the fight against malaria.

Ms McCord said there was need to bring the global community on board for increased funding and emphasised the need for continued distribution of mosquito nets. She commended US President George W Bush for launching the 2005 Presidents Malaria Initiative pledging to increase the US malaria funding by $1.2billion over five years, to reduce deaths by 50 per cent in 15 African countries.

Novartis director of public affairs, Rebecca Stevens said her company, which manufactures Coartem is currently developing a 95 per cent cure rate for paediatric cases. Ms Stevens said as a world leader in offering medicines that protect health, cure diseases and improve well being-without profit- Novartis has provided over 140 million coartem treatments to malaria patients worldwide since 2001, thus contributing to saving lives. Ms Stevens said 75 per cent of the 140 million Coartem treatments were for infants.

Another expedition sponsor, Olyset Net spokesman, John Lucas declared that society was winning the battle against Malaria through collaboration such as the expedition.

Chaka Chaka said she had been ignorant about malaria, until five years ago when it killed her fellow musician and dedicated her life to fighting it and ensure it was defeated. Exon-Mobil medical director for global issues and projects Stephen Phillips said the expedition was a sample of what could be achieved through partnership.

Dr Phillips said the expedition was one of the symbolic examples of partnership ad described it as a sign of the political will shown by the leadership.

Netsforlife representative, Robert Radtre said he was happy with the well documented behavioural change and that malaria had shown no borders and looked forward to reaching many people.

Vice-President Rupiah Banda declared that Zambia will stay in the global partnership against malaria until it is defeated.

Mr Banda said Zambia has started to reap positive results from its investment in malaria control as indicated by the 2007 health management information system which had also shown reduced malaria cases.

He described Zambia's hosting the WMD as an honour, apart from being appropriate for the Livingstone city as the famous Scottish missionary and explorer David Livingstone, whom the town is named after, had died of malaria.

The Vice-President said the Zambian Government noted the successes of collective efforts and hoped the current momentum would be sustained to a point where society would be free from malaria.

Mr Banda, who saluted the various partners in the fight against malaria for their unwavering commitment said malaria had ceased to be an African disease, but a global challenge, hence the more active involvement from international organisations and individuals from the developed world.

He said the theme of the World Malaria Day 'Malaria-A Disease Without Borders' with its accompanying slogan, "United against Malaria", was appropriate because Malaria was now a global health problem. The Vice-President said the WMD was a culmination of African leaders commitment made at the 2000 Abuja summit in Nigeria, where they declared to reduce malaria illnesses and deaths by 50 per cent by the year 2010.

In the declaration, the leaders pledged to introduce and intensify malaria control interventions and ensure 60 per cent of Africans accessed cost effective and affordable anti malaria drugs, 60 per cent, especially pregnant women and children sleep under ITNs and 60 per cent of pregnant women to access international preventive treatment (IPT). Evidently, Zambia has made tremendous efforts towards achieving RBM goals, by placing health as a priority sector focussing on the attainment of the national development goals and the Malaria related Millennium Development Goals (MDGs).

He said Zambia had achieved increased ITNs use, effective anti-malaria efforts, availability of tools to diagnose malaria and ensure proper management of malaria and increased coverage of IPT for pregnant women.

The Bill & Melinda Gates Foundation and the Medicines for Malaria Venture(MMV) are helping to develop new drugs, while the US President's Malaria Initiative, Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank's Booster Program for Malaria Control in Africa are working with ministries of health on delivery and access issues. More importantly, about 70 per cent of pregnant women in Africa attend antenatal clinics at least once during their pregnancy.

A regime of SP helps protect pregnant women from possible death and anaemia and also prevents malaria-related low birth weight in infants, which causes about 100,000 infant deaths annually in Africa.

Solutions to fight Malaria has been reduced and even eliminated in many parts of Asia, Europe and the Americas. Yet in Africa, with very efficient mosquito vectors, increasing drug resistance and struggling health systems, malaria infections have actually increased over the last three decades.

To control malaria, and to ultimately assure families of malaria-free lives, the use of ITNs, indoor residual spraying(ISR), increased access to diagnosis and anti malarial drugs, will help stop Malaria. In addition, strengthened antenatal care services for pregnant women, education - empowering families and communities with the knowledge and resources to combat this disease are also vital steps. And while working to control malaria through available tools, there is need to continue supporting the development of a vaccine.

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Combating malaria misdiagnosis

from IRIN

Health experts say the majority of malaria cases in Mali are misdiagnosed, which causes resistance to malaria drugs and leaves other illnesses untreated.

“When people are sick in Mali, the doctor will usually tell them they have malaria whether or not they test for it,” said Fatou Faye, an infectious diseases researcher and trainer at a privately funded medical laboratory, the Charles Merieux Centre in Bamako.

“The patients then buy anti-malarial drugs in the street and build up a resistance to treatment.”

As a result, according to research by Dr. Imelda Bates at the Malaria Knowledge Project (MKP), part of the Liverpool University School of Tropical Medicine, this means people miss other causes of feverish illness such as pneumonia and meningitis, which can cause further illness and even death.

Economic productivity is also affected, and misdiagnosis can deepen poverty due to prolonged illnesses and money being wasted on the wrong drugs.

Malaria is the most prevalent disease among Malian children under five years old according to George Dakono coordinator of with the national project to fight against malaria.

“Shocking levels” of misdiagnosis

The discrepancy between real and assumed cases has reached “shocking” levels all over Africa according to the MKP.

Malaria diagnostics in Mali rely on expensive equipment which most health clinics, particularly in rural areas, cannot afford and do not have the trained staff to use, Michel Van Herp an epidemiologist with non-governmental organisation Médecins Sans Frontières (MSF) Belgium, told IRIN.

As a result most doctors “make assumptions based on suspicion,” he said, leading to over-treatment of malaria cases.

Further, according to Dakono and Faye, most people who develop a fever in Mali do not visit a health clinic at all, either because they live too far away or are unwilling to pay up to US$0.95 for a consultation. They self-diagnose and treat instead.

Up to 70 percent of cases of feverish illness in children are diagnosed and treated at home according to the MKP.

Laboratories the ‘gold standard’

Mali needs more and better-equipped laboratories to combat mass misdiagnosis, according to Faye.

Valentina Buj, a health project officer with the World Health Organization (WHO) said “blood smear-tests in a laboratory are the gold-standard in malaria diagnostics.”

But the majority of the 82 government-run laboratories around the country lack the right equipment and trained technicians to diagnose malaria, Faye told IRIN.

The Charles Merieux Foundation has set up a laboratory in Bamako to diagnose malaria and other infectious diseases, train technicians from health clinics around the country in how to use diagnostic equipment and run a lab, and with European Union funding, to equip labs around the country. Its aim is to replicate standards found in French laboratories.

“We want to create a situation that for the majority of diseases they encounter, they can accurately diagnose them themselves,” Faye said.

Rapid diagnostic tests

But for MSF’s Van Herp, laboratories are not the answer to improving malaria diagnostics in rural Mali where clinics and laboratories are few and far-between.

“We need simple, low-technology malaria test kits, rather than buying more expensive equipment and carrying out in-depth trainings which is hard to do in rural areas,” he told IRIN.

For him the answer is to get rapid diagnosis tests or ‘RDT’s, which are small, easily transported and cost on average US$0.45, to community health workers throughout the country so they can test people village by village.

“The test takes 15 minutes to produce results and it takes half a day to train a community health worker how it’s used,” said Van Herp, “they are the only options for diagnosis at the household level.”

The test is simple - if a person has malaria, chemicals in the test react to a product produced by the malarial parasite in their blood, causing a red strip to appear fifteen minutes later. And where MSF has distributed them, the number of patients seeking diagnosis for malaria has increased from one in four to 100 percent.

Taking the kits country-wide is a challenge in Mali -– they require a long shelf-life, sophisticated distribution systems, and their results are unreliable in temperatures of over 30 degrees Celsius, which is Mali’s average temperature. “The technology still needs to be finessed,” Buj said.

MSF nonetheless says it plans to expand its programme, which currently is diagnosing 80,000 people in malaria-prone regions, across the country alongside the government.

Funding

With simple technology, improving diagnostics does not have to be expensive – it would take US$61 million to cover Mali’s diagnostic needs according to Van Herp - but it requires the government and donors to take it more seriously.

The first step, according to the MKP is cost-benefit analyses to map out malaria prevalence, resistance patterns, and clinics capacity to analyse which diagnostics approach is better – rapid tests or improving labs.

International donors have stepped in to improve Mali’s efforts to fight malaria with US$126 million from the George Bush foundation and the Global Fund to fight HIV/AIDS, malaria and tuberculosis committed over five years, but critics say not enough of this money targets diagnostics.

“The Ministry of Health is already subsidising medicines, staff salaries and building health centres, and international funds are coming in, so why shouldn’t it start supporting diagnostics fees as well?” asked Van Herp.

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UMC gets $5 million for anti-malaria efforts

from the Dallas Morning News

The grant was announced at the UMC's General Conference, underway in Fort Worth. Details below:

United Methodists Receive $5 Million To Help End Child Malaria Deaths
Grant Announced On World Malaria Day

FORT WORTH: As it commemorates World Malaria Day, The United Methodist Church announced today it will receive a $5 million grant from the United Nations Foundation, with support from the Bill and Melinda Gates Foundation, to help eliminate malaria and other diseases of poverty.

Bishop Thomas Bickerton revealed the grant at the United Methodist General Conference, the denomination's top legislative body meeting in Fort Worth through May 2.

"We hope to use this $5 million to support a fundraising and educational campaign to help end deaths of children from malaria. The goal is to raise $100 million over the next several years for programs in Africa to fight malaria, HIV/AIDS, tuberculosis and to support the Global Fund," said Bickerton.

The United Methodist Church is embarking on a global health initiative aimed at combating diseases of poverty. The denomination has recently entered into an expanded partnership with the United Nations Foundation to help end malaria deaths.

"The United Nations Foundation's Malaria Partnership is proud to be working with The United Methodist Church to help eliminate malaria deaths," said Elizabeth McKee Gore, executive director of partnership alliances at the UN Foundation."The church's 11.5 million members have already been sending anti-malaria nets and saving lives through the Nothing But Nets campaign. We are looking forward to continuing to fight malaria through the Malaria Partnership."

The people of The United Methodist Church are founding partners in Nothing But Nets, a campaign to prevent malaria by sending life-saving insecticide-treated mosquito nets to children and families in Africa. More than $18 million has been raised to date and more than 700,000 nets have already been delivered to families in Africa.

Earlier this week, Bickerton joined philanthropist Ted Turner, sports columnist Rick Reilly, NBA Commissioner David Stern, and a host of religious, civic and business leaders representing more than 25 million people around the world to announce organizational commitments to end malaria, a disease that kills more than 1.3 million people each year.

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Rural farmers turn malaria medics in Sierra Leone

from Tropix via Reuters

By Katrina Manson

MALLAY, Sierra Leone (Reuters) - A year ago Adama Jongo, a rice and cassava farmer in Sierra Leone, almost died from malaria while pregnant.

Now, the 37-year old mother of seven has turned volunteer medic to fight the disease under a pioneering scheme to bring life-saving healthcare closer to rural communities.

Malaria is the number one killer in Sierra Leone, a former British colony in West Africa ranked by the United Nations as the least developed country in the world.

Under a pilot scheme run by aid group Medecins Sans Frontieres (MSF), Jongo has been given a tester kit and trained to care for the most vulnerable in her village, a collection of mud huts 200 km (124 miles) southeast of the capital Freetown.

Instead of resorting to traditional medicine and "pehpeh doctors" who deal in out-of-date or fake medication, pregnant women and young children too weak to travel to far-off health centers can turn to Jongo for effective drugs and care.

If the tester kit shows they have malaria, Jongo administers a 3-day course of drugs she keeps locked in a special box.

Although free treatment is sometimes available in Sierra Leone to fight the mosquito-borne disease -- whose deadliest strain is common in the country's mangrove swamps and tropical forests -- many cannot get to health clinics in time.

"Some women are child bearing and pregnant so it's difficult for them to get to a clinic because they are attacked with malaria and fever -- it gives them problems to walk," Jongo said, her 9-month old baby in her arms.

The program is one of a number aimed at eliminating malaria, ranging from handing out insecticide-treated beds to prevent mosquito bites to providing greater access to potentially lifesaving drugs.

The idea in Sierra Leone is to ensure free medicine is available on the spot for pregnant women and children aged under five -- those most likely to die if not treated within the first 48 hours -- who live in communities more than 3 km (2 miles) from the nearest clinic.

Jongo's fellow villagers have no mobile phone signal or vehicle and have to be carried for hours in a hammock by four men to reach medical treatment. Some arrive too late.

"My people are always attacked with malaria. They are not getting drugs and the distance is too far: they die," she said.

The scheme will be piloted in more than 200 villages across southern Sierra Leone and the government hopes to introduce this sort of free home-based care and medication across the nation.

"I want to help my people," Jongo said. "That's why I have given up (my time). Now mothers can come to me any time of the night when their baby is attacked with fever."

COUNTING THE COST

According to the World Health Organization, prompt and effective treatment of malaria can reduce death rates by half.

But a recent study by Sierra Leone's Ministry of Health showed that only 12 percent of children aged under five received efficient and appropriate treatment.

Worldwide, more than 500 million people become severely ill with malaria every year. One child dies of the disease every 30 seconds.

Many Africans suffer several bouts a year, not only making them seriously sick but also taking them away from jobs or work.

Continent-wide, the Global Fund to fight AIDS, Tuberculosis and Malaria estimates the illness costs Africa more than $12 billion every year in lost gross domestic product, even though the fund says it could be controlled for a fraction of that amount.

"Malaria is a major threat to the socio-economic development of the country with an estimated 7-12 days lost on average per episode of malaria," said Edward Magbity, Monitoring and Evaluation Specialist at Sierra Leone's Ministry of Health.

"It is a disease of poverty as a cause and a consequence."

According to World Health Organization's Commission on Macroeconomics and Health, up to $2 billion is needed a year to halve the burden of malaria by 2010. Currently, there is an annual shortfall of $1.4 billion.

QUACK REMEDIES

Innovations in drug technology have produced malarial treatments for less than $1 a course and test kits for $0.75.

But in a continent where many live on less than $1 a day, that can be too much. Faced with long distances and the expense of traveling, many resort to traditional medicines or the untrained pehpeh doctors.

"We are going into competition with the drug peddlers," said Willemieke Vandenbroak, head of the MSF's Sierra Leone mission.

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Fighting Africa’s true crisis

from the South Florida Times

BY DENNIS PINTO
In today's world, it's important to read between the headlines.

For instance, if Kenya and its African neighbors received the same kind of mass media attention about its most profound problems as it has about its recent post-election troubles, then perhaps the continent could make some true headway in its battles against extreme poverty, chronic hunger and HIV/AIDS.

But alas, it sometimes seems these critical issues, which are the root problems underlying the post-election incidents, are not newsworthy enough to make headlines.

Indeed, Kenya's post-election riots are known by many newspaper readers, yet few know that an African child is orphaned by AIDS every 14 seconds. It has been well documented that 1,000 people have died in the two months since the disputed Kenyan election, but it is also true that 3,000 people die of malaria every day in sub-Saharan Africa.

As a Kenyan living in New York and the owner of a large safari outfitter operating in East Africa, I received daily news updates from the Kenya Tourism Federation, as well as reports from our staff on the ground during the recent unrest.

The striking discrepancies between what I heard from my Nairobi-based staff and fellow Kenyan tourism suppliers and what was portrayed by news outlets were astounding. The situation was neither as apocalyptic nor the violence as pervasive as implied in the news. Incidents were taking place almost exclusively in the heavily populated slums of major cities or in remote country areas-not in the vast majority of city neighborhoods and not on the typical tourist tracts.

According to the Kenya Tourist Board, there were 40,000 tourists in Kenya during the turbulent post-election weeks, none of whom were harmed or inconvenienced in any way.

Too often, Africa's most pressing problems have not received the attention they deserve, and the African people have suffered because of it. Newspapers certainly have a responsibility to report the news, but those reports should not be limited to sensational, occasional problems.

If members of the media want to highlight problems in Africa, then I call upon them to report on the formidable menaces that plague Africa every day. As
Nobel Peace Prize nominee Bono writes in The End of Poverty by Jeffrey D. Sachs, “Fifteen thousand Africans die every day of preventable, treatable diseases – AIDS, malaria, TB – for lack of drugs that we take for granted...This is Africa's crisis.”

What can the average person do?

Do not give up on Kenya. Ever since Kenya's independence 40 years ago, whenever the country has experienced any sort of domestic incident, pundits have predicted the demise of the country.

This, of course, has never been the case. Kenya has prevailed as a model of stability and democracy in the otherwise volatile horn of Africa.

While a peaceful resolution to the disputed election has now been reached, the future remains bleak for those Africans who fight daily battles with hunger, poverty and disease. For more than 20 years, Micato's nonprofit foundation, AmericaShare, has been supporting residents of Nairobi's slums by providing access to such basic services as clean water, food, health care and an education. The efforts of AmericaShare and other worthy organizations, however, are largely ignored by the media.

Dennis Pinto is the managing director of Micato Safaris in New York, named the World's Best Tour Operator & Safari Outfitter by Travel+Leisure magazine for five consecutive years, and a founder of Micato's nonprofit arm, AmericaShare.

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War fever: Malaria in conflict

from the BBC

On World Malaria Day, Chris and Xand Van Tulleken, working with the aid agency Merlin, highlight the devastating link between conflict and rates of malaria infection.

When we were studying tropical medicine in London, a favourite trick of one professor was to ask students what we thought the deadliest animal in the world might be.

One Ghanaian colleague suggested a lion riding on the back of an elephant, eating and trampling everything in sight.

But the required answer was the humble mosquito - or more precisely, the anopheles mosquito, the carrier and transmitter of malaria, a disease which kills over one million people every year.

This rather clever answer isn't entirely true.

Anopheles mosquitoes are found in harmless abundance in many places on earth. Malaria, once widespread even in Kent, has been eradicated from Europe and North America, as well as many parts of Asia.

Why then does it persist with such deadly effect in some parts of the world?

Information vacuum

Poverty and weak health systems contribute hugely to the problem, but another, largely overlooked, factor is responsible for nearly 30% of all malaria deaths in Africa - conflict.

In 2007, 26 million people were driven from their homes by conflict. The effects of climate change - and conflict over limited resources like water, food and land - mean that every year, larger numbers of people are likely to be displaced.



When people flee conflict, they don't take hospital records with them. They don't take demographic data or disease patterns or any of the other details needed to tackle malaria.

They are often settled on land which has been abandoned because of the risk of malaria, or forced to live in over-crowded camps with limited health services, water, food and shelter.

In this vacuum of information and mass displacement, malaria is at its most deadly: frequently, more people die from the disease than the actual violence.

The British medical aid agency, Merlin, has been running emergency mobile clinics in Kenya's Rift Valley province since post-election violence forced hundreds of thousands to flee their homes.

More than 32,000 terrified people flooded into Nakuru district in the Rift Valley alone. Medics working on the ground simply don't have records of drug resistance levels or immunity for the displaced families now living in camps.

Cases of malaria are normally quite low in Nakuru, but with so many new people in the area, Merlin is aware that the chance of disease patterns changing is high, as is the risk of an outbreak.

Monsieur Paracheck

Experience shows that there is no single effective solution to controlling malaria; mosquitoes, resistance to drugs and people's immunity all vary greatly from place to place.

Insecticide-treated bed nets have a vital role to play in preventing malaria, as Gordon Brown's recent pledge of $200m to fund mass net distribution demonstrates.

But nets don't work so well if, like many displaced people, you have no bed, and no home.

Likewise, destruction of mosquito breeding sites can control the disease, but first you must know whether the local bugs breed in dirty, sunlit ground water or clean water in dark places.

Applying insect repellents to skin helps, but only if you know when the mosquitoes are likely to bite; anopheles gambiensis bites indoors at night (so bed nets work well), anopheles bellator bites outdoors at dusk.

Diagnosis poses similar problems.

Parachecks are rapid-test malaria kits, much like pregnancy tests. I used them to monitor for a malaria outbreak in Darfur; they were quick and easy for local staff to learn to use. My colleague who performed the tests was so proficient that he was popularly, and respectfully, known as Monsieur Paracheck.

These tests are not however appropriate in all settings and their usefulness depends on the number of people affected with the disease, the types of malaria, and the diagnostic information needed.

Treatment, again, varies. Drugs which can be effective within hours in one part of the world, may have such high resistance elsewhere to render them useless.

Malaria prevention, diagnosis and treatment require intensive, local information gathering which is often extremely difficult when people are still migrating or when violence is rife.

But all are essential to understand quickly and implement early if, as predicted, the trend for mass displacement caused by conflict continues to rise.

Insecticide on burkas

Solutions have to be tailored to specific circumstances.



An effective programme for Afghan refugees in Pakistan, rested on the discovery that the malaria mosquitoes there mostly feed on animals, and the displaced communities often live with their livestock so are constantly exposed to bites.

"Research showed that by coating the livestock with insecticide, malaria rates plummeted", explains Merlin's malaria advisor, Dr Ahmed Fayaz.

"But there were also unexpected benefits: the animals gained weight and milk production increased. These welcome side-effects ensured farmers continued to use the insecticide which protected them from malaria."

Sadly, these methods won't work in Africa, where mosquitoes tend to feed on people.

Nonetheless it is ideas founded in local knowledge such as these, or the technique of applying insecticide to women's burkas in Muslim countries, which can help save lives.

Chris and Xand Van Tulleken presented the Channel 4 series Medicine Men Go Wild. Xand lectures on international public health at University College London, and Chris is a Senior House Officer in Infectious Diseases.

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Expedition Nets Fly in the Face of Malaria

from Eco Worldly

Written by Sam Aola Ooko

On April 25, 2008, designated the first World Malaria Day, 3,000 children or more in sub-Saharan Africa, majority of them under the age of five years, will die from malaria, one of the deadliest preventable diseases on the planet, global health data indicate.

Malaria, the dreaded and life-threatening disease continues to kill between 1 million and 3 million people each year, many of them pregnant women in Africa.

A two-month long 2,500 kilometers (1,550 miles) expedition on the Zambezi, one of Africa’s longest rivers, that begun on 29 March 2008 led by two adventurers, Helge Bendl, a journalist, and Andy Leemann, a boating enthusiast, partnering with the Roll Back Malaria Partnership, covering six nations in southern Africa aims to put a spotlight on the plight of malaria-stricken communities on the continent which contributes 90 percent of the global annual death toll.

The rough terrain in Africa means that the delivery of mosquito nets and medications to remote villages ravaged by the disease could sometimes be a matter between life and death. But with inflatable boats through Angola, Namibia, Botswana, Zambia, Zimbabwe and Mozambique, the Zambezi Expedition will attempt to get even deeper to reach to many potential victims as possible.

Sponsored by Sumitomo Chemical, the expedition includes medical teams carrying ecologically safe mosquito nets and medicine. The organizers hope it will also raise more local and global awareness to scale up malaria control and prevention and provide renewed life for malaria prevention in Africa as well as educate families with the knowledge and resources to combat the disease. Nearly 40% of the world’s population lives in malaria-endemic areas.

Previously marked as Africa Malaria Day since 2001, World Malaria Day is an attempt to raise greater awareness and global commitment to rolling back malaria and meeting the United Nations malaria-related Millennium Development Goals.

Caused by a parasite that is transmitted by mosquitoes that typically bite their victims at night, malaria can kill very quickly if untreated and remains the leading cause of death in many developing countries, particularly among children.

Unlike many parts of the world where it has been eliminated, malaria infections have, over the last three decades, increased in Africa, compounded with very efficient mosquito vectors, increasing drug resistance and struggling health systems.

Approaches like providing insecticide-treated bed nets, spraying the inside walls of houses with insecticides, providing access to diagnosis and antimalarial drugs, and providing a packet of interventions through strengthened antenatal care services for pregnant women have been known to be effective against the disease.

Long-lasting insecticide-treated bed nets (LLINs), that have no adve